NPIMap

Organization Active NPI

Advanced Eye Medical Group a Professional Corporation

  • Ophthalmology Physician
  • Mission Viejo, CA
National Provider Identifier
1003968017
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ADVANCED EYE MEDICAL GROUP A PROFESSIONAL CORPORATION
Practice address
26701 Crown Valley Parkway
Mission Viejo, CA 92691
Phone
(949) 582-1090
NPI assigned
Jan 18, 2007
Last updated
Apr 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ribhi K Ghosheh, MDNPI 1659474112
Title
President Director
Phone
(949) 582-1090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X CA Primary

Addresses

Primary practice location

26701 Crown Valley Parkway
Mission Viejo, CA 92691

Mailing address

26701 Crown Valley Parkway
Mission Viejo, CA 92691
Phone (949) 582-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050630001185 CA Part B Supplier - Clinic/Group Practice 1052357803 Receives reassigned benefits from 8 practitioners
Practice locations: Mission Viejo, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Advanced Eye Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

26701 Crown Valley Pkwy
Fl 2
Mission Viejo, CA 92691

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1003968017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26701 CROWN VALLEY PARKWAY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-582-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26701 CROWN VALLEY PARKWAY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-582-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYE MEDICAL GROUP A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "GHOSHEH",
        "authorized_official_first_name": "RIBHI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "949-582-1090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.